Atos Case Study CIZ

Case study
Higher efficiency,
lower costs and
effective healthcare
DevOps and Scrum at the basis of successful implementation national CIZ indication system
Over 25,000 suppliers of health care
services consider it self-evident that they
are able to apply for 1 million indications at
the Dutch Centre of Healthcare Indications
(CIZ) every year. This amounts up to a total
sum of 27 billion euro. CIZ gives an indication
or estimates if these claims for AWBZ care
have legitimacy. With an indication of CIZ
citizens know which healthcare services they
are entitled to and in which form these will
be offered to them. However, as from 1.
January 2015 a radical shift will take place.
A considerable amount of health care services will be included into the Wet maatschappelijke ondersteuning (Wmo) en
Zorgverzekeringswet (Zvw). As part of this
transformation tasks will be shifted to partners of CIZ: municipalities and insurance
companies. This transfer will trigger sub
stantial budget cuts as well.
The system that facilitated these processes
in the past reached the end of its lifecycle in
2013. In order to be prepared sufficiently for
all the upcoming changes CIZ focused its
information strategy on the implementation
of flexibility and scalability as well as on
making its key systems and IT infrastructure
future proof. In order to realize this, CIZ has
developed the new IT system Portero in cooperation with Atos, replacing the old system
dating from 1994. On 25. November 2013
Atos delivered a completely new information
system for the evaluation of application for
ABWZ health care services. Atos was responsible for the design, development and the
testing of all applications. Moreover, it built
an OTAP environment and supported the
migration of data from 17 databases to one
new uniform system.
Portero: the best sum of parts
In the Netherlands CIZ indicates and checks the
applications for AWBZ healthcare services: from
individual care and nursing, up to counselling
and short stays. CIZ is the independent starting
point in the Dutch health care chain. It estimated
whether a client is entitled to extensive AWBZ
health care. Every year CIZ processes approximately one million indications and allocates an
amount of 27 billion euro.
CIZ was formed in 2005 as a result of a merger
between 80 organizations. In the past the key
processes of CIZ – the assessment and allocation
of indications for ABWZ health care services -
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were supported by an information system
dating from 1994. It was the result of the integration of 78 unique systems. The system
comprised no less than 17 databases and was
not able to anticipate upcoming changes in
legislation. CIZ selected Atos for the development of a completely new indication system:
Portero. This migration aimed to realize more
efficiency at lower costs. Portero enables
optimal digital process support and has the
scalability in order to prepare the system for
the upcoming decentralization of the ABWZ.
Moreover, the system is flexible enough to
adapt itself to changes in legislation.
Higher efficiency, lower costst
and effective healthcare
Within time and budget
Atos was able to implement the new indication
system Portero within time and budget. During
10 months 50 employees have worked inten
sively to make this happen. Only a few arrangements had been made beforehand: contract
negotiations were continuing, there were no
specifications, there was no architecture for the
software and OTAP environment. A data model
and source code were lacking as well. Only the
quality requirements, the budget and the date
of delivery were fixed. Atos delivered a completely new information system for the evaluation
of application for ABWZ health care services.
Part of going live was the extensive migration
of databases, including over 15 million client files
and 11 million documents. Before the new
system went live the data migration of the existing system as well as technical transformation
to Portero were tested several times. During this
process there was a lot of attention for the
testing of critical processes with partners within
the health care chain, in particular the College
voor Volksverzekeringen and 32 connected
health care providers. All data were migrated
from the old system to Portero. The system was
shut down on the Thursday before the weekend
when the migration was planned. On Monday
morning employees were able to settle their
files in Portero.
Scalable, flexible
and efficient
The new software comprises over 3,000
function points and the software architecture
is future proof in terms of process and organi
zational changes. This is possible, because the
application design is based on organization
model. Moreover, Portero is very scalable and
flexible and sufficiently prepared for the upcoming decentralization of the AWBZ function.
Flexible in order to adjust to an ever changing
and very dynamic playing field, partly as a result
of new legislation. Moreover, Portero meets all
the requirements of the government, municipalities, 2,000 health care providers as well as
1,400 CIZ employees. It contributes to a swift,
effective and efficient health care service with
shorter handling times, better indications as well
as substantial cost reductions. The results speak
for themselves: on 31. December 2013 100,000
applications were settled in Portero and on 31.
January 2014 100,000 new applications were
implemented. The system has 13,000 unique
users and 1,400 internal users within CIZ.
“An effective co-operation based on a
partnership with a shared focus on results.
Enabled by a professional management
of Atos aimed at quality, productivity and
project management”.
Manda Oplaat, CIZ
The primary processes are based completely
on the Cordys BPMS platform of CIZ. This platform enables business and IT to develop software together. It contains logically automated
process steps. As a result the software is very
user-friendly for CIZ employees and partners
in the health care chain.
The accessibility of the system for citizens and
health care providers - for the swift registration
and monitoring of health care applications was realized by means of a web application.
This application has been developed with
open source software Grails. Portero is connected with basic administrations (GBA and SBV-z)
and the health care chain (CVZ and 32 connected health care offices). An important benefit of
Portero is the secure IT infrastructure. The new
system runs in a special security zone in order
to guarantee the confidentiality of health care
data. The quality of codes as well as security
is ensured by external auditing as well.
The Portero code has been certified with
four stars by SIG.
Scrum & DevOps
Effective co-operation
The quality required, the budget and the
deadline for delivery were fixed beforehand.
The advantages of this successful approach
are based on the effective co-operation that
resulted in a considerable user acceptance
and delivery within time and budget.
Every sprint resulted in to a well-functioning
product. All results have been demonstrated
to the CIZ management and end-users. During
these sprints ‘operational sets’ have been developed, implemented and managed. In particular
the timely involvement of IT management
during the Scrum sprints has made a difference.
Therefore, the software not only meets high
quality standards but strict management
requirements as well.
As a result of this effective approach CIZ is able
to implement a new release every week if this
is required. The implementation costs of new
functionalities have been reduced with 30 per
cent and the IT department of CIZ has been
down-sized with almost 50 per cent.
CIZ and Atos have used the Agile/Scrum
method for this project and operated from one
central location in multidisciplinary teams in
order to develop, deliver and manage ‘operational sets’ during 13 sprints of 3 weeks (DevOps).
For more information: [email protected]
nl.atos.net
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April 2014 © 2014 Atos.

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